HomeMy WebLinkAboutPermit Building 1994-9-12
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
lOCATION OF PROPOSED WORK' (07 grLI Mu.m Sf-
ASSESSORS MAP' 11 tJ '7-34 lj I
lOT'
BLOCK'
OWNER' l' ~ *,,j i: I-b,l/\
,
ADDRESS" Po '.f)z>>e 7_1 C; a:r
CITY: ~~
DESCRIBE WORK' Il~ V7l::r y.e 0 t!I ; (
NEW REMODEL ADDITION
STATE: ~L
DEMOLISH OTHER
.
c?Lf1403
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX lOT:
t')(,,:(0 I
SUBDIVISION:
. PHON'"
fo~9 ~ 7'-17_c'
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ZIP: Ql\f..!1D
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CON ST.
ADDRESS CONTRACTOR'
(75<<Jf7utt.,. u.. Cr/j C(N,,/ t1.?0Si
CONTRACTOR'S NAME
GENERAL: fd ~([i\A~INIJ"A
PLUMBING'
MECHANICAL'
ELECTRICAl'
EXPIRES
1lq5
,
PHONE
qC:;L/-/AL/~
- OFFICE USE -
QUAD AREA' lAND USE: FLOOD PLAIN:
· OF BlDGS: · OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
· OF STORIES: HEAT SOURCE: _ SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested belore 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 8.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to fflllng
trench.
o Storm Sewer - Prior to filling
trench.
o Water line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough MechanIcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrIcal power.
o Fireplace - Prior to facing
~nd framing Insp.
L.LJ ~ramlng - prlo.r to cover.
o Wall/Cafflng Insuletlon - Prior to
cover.
o Drywall - Prior to taping.
o Wood StOVQ - ^;fter Installation.
o Ins8rt - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
o Street Trees - When all requIred
trees are planted.
o Final Plumbing - When all
plumbing wt;>rk Is complet.e.
D Final Electrical - \NotIen all
electrical work Is complete. ~
o Final Mechanical - When all
7 work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - Whe[l all
blocking Is complete.
o Plumbing Connections - When
home has been connected to .
water and sewer.
D Electrical Connection - When
blocking, set-up, and pluroblng
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type.
Interior
." :',c \:I~;.,~t.\:)
. THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
lot sq. Itg.
Setbacks
HSE GAR ACC
Topography
Panhandle
I P.l.
IN
Is
Iw
IE
APPROVED:
Lot coverage
Corner
Total t;elght
Cul-de-sac
ITEM
SQ. FT.
X $/SQ. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMIT
Building Permit Fee
State Surcharge
1')( 10.CD
" -
~ \ ,ex.
. '5~'
\, ,
~2 ,6()
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any tIme
upon violation of an\P~s O~Of said or es.
Plan Check Fee: "-.)
~
Date Paid:
f..1aln
Ga(age
"
Carport
Total Value
Receipt Number'
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC) .
(B)
Systems Development Charge Is due on all undeveloped
properties withIn the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
.
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By signature, I state and agree, that I have carefUlly examined
the completed application and do hereby certify that all
Information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnserllFlreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
Total Permit
(D)
I further agree to ensure that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the permit card Is located at the front
of the property. an approved set of plans will remain
on the site all ti during nstructlon.
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/
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Date
9~/Z-'i''/
---
Curbcut
It
Demolition
State Surcharge VALIDATION: \ 0 r O~
RECEIPT NUMBER '\r ~>-......J I
Total Miscellaneous Permits (E) ~ ,'>(^ DATE PAIr> ~ - \' rl '-1 C\ ~, .' f7:'
, . ~ -' AMOUNT RECEI~E ?.~, -5 - ':S-;;. '- /)
TOTAL AMOUNT DUE (excluding electrl<jEllf' CJ7'. '1':l ~
(A, B, C, 0, and E Combined),....., '7 \.l 'h ,,;-,,,:,:::- . ~ECEIVED BY " '
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